New HSE programme aims to reduce suicide rates

US expert training over 150 health service staff in treatment methods

The 2012 national male rate of self-harm was 195 per 100,000 - up 20 per cent since 2007 - while the national rate of female self-harm was 228 per 100,000 - up 6 per cent over the same period. Photograph: Reuters

A new self-harm treatment programme which is being adopted by the HSE could help reduce suicide rates and emergency hospital visits by half, according to an expert in the field.

US based psychologist Prof Marsha Linehan is in Ireland this week training over 150 HSE staff in the new treatment technique, Dialectical Behaviour Therapy.

According to Prof Linehan, people who repeatedly self-harm are often diagnosed with borderline or emotionally unstable personality disorders.

People with such personality disorders have difficulties in managing their emotions and engage in repeated deliberate self harm and suicide ideation.

“Dialectical behaviour therapy (DBT) is a trans-diagnostic intervention that has varying levels of intensity depending on the person’s level of disorder,” said Prof Linehan.

“You must match the intervention to the individual’s needs and those that are highly suicidal need the full standard DBT treatment,” she added.

According the National Registry of Deliberate Self-Harm, some 9,483 people presented a total of 12,010 times at hospitals in 2012 due to deliberate acts of self-harm.

The 2012 national male rate of self-harm was 195 per 100,000 - up 20 per cent since 2007 - while the national rate of female self-harm was 228 per 100,000 - up 6 per cent over the same period.

According to Prof Linehan, studies have shown standard DBT cuts both suicide rates and emergency department visits by 50 per cent compared to other expert non-behavioural treatments.

The technique also reduces in-patient admissions by 73 per cent but practitioners need to be properly trained in giving the treatment, said Prof Linehan.

“The Irish trained therapists are more sophisticated than many of the people I’ve worked with and I’m very impressed by their high level of commitment,” she added.

HSE Principal Psychology Manager Daniel Flynn said Prof Linehan was so impressed with HSE staff in January, she agreed to return to train them in new DBT skills.

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He said that Prof Linehan’s visit reflected well on both the staff and the programme put in place by the HSE and National Office for Suicide Prevention to provide DBT nationwide.

Clients who have attended therapy have felt that it has helped them rebuild their lives and cope with their self-harming and suicidal behaviour tendencies, said Mr Flynn.

One woman, Mary (not her real name) said she had been treated with medication and attended counsellors and pyschologists but nothing had helped her cope with her depression.

She was referred to the HSE’s North Lee Community Mental Health Team outpatient clinic in 2011 where was assessed with Borderline Personality Disorder.

“I participated in DBT for a year and on completion in 2013 I have learned to deal with my life in a much healthier way,” said Mary (41).

“I stopped self-harming completely and the thoughts of suicide are gone. I’ve stopped judging myself harshly and have learned to deal with my anxiety, my thoughts and my depression.

“ Participating in the programme was difficult but it was worth every second. Nowadays, I am more confident and more in control of myself, my reactions and my life overall.”